Oxidative balance score, genetic susceptibility, and the risk of pancreatic cancer: a population-based cohort study

Pancreatic cancer (PC) is one of the deadliest cancers, largely due to its prolonged asymptomatic progression. Identifying and mitigating risk factors is critical for reducing PC incidence. Although oxidative balance score (OBS) is a potential modifiable factor for preventive interventions, its association with PC risk remains unclear.

The study included 157,527 participants from the UK Biobank, all of whom were free of PC at baseline. OBS was calculated using 16 diet-lifestyle components derived from a validated self-reported questionnaire. A higher OBS indicates a profile richer in antioxidant factors and is thus considered potentially protective. A genetic risk score for PC was constructed based on 44 established PC susceptibility single nucleotide polymorphisms. Cox proportional hazards models were employed to assess the associations between OBS and incident PC, adjusted for demographic, socioeconomic, lifestyle, clinical factors, and genetic covariates. Multiple sensitivity analyses, including Fine and Gray competing risk analysis, were performed.

Over an average follow-up of 9.96 years, 513 participants developed PC. In the overall population, participants in the highest quartiles of OBS had lower adjusted hazard ratios (HR) (95% confidence intervals [CI]) for PC: 0.71 (0.54, 0.94), compared to those in the lowest quartiles. Similarly, men in the highest OBS quintile had significantly reduced PC risk, with an adjusted HR of 0.57 (95% CI: 0.39–0.82). However, no significant association was observed between OBS and PC in women (HR = 0.92, 95% CI: 0.61–1.40). No significant interaction between OBS with sex and genetic susceptibility was found.

OBS was inversely associated with PC risk in men, suggesting that promoting a healthy lifestyle to increase OBS could lead to an associated reduction in PC burden.